Phonological treatment of apraxia of speech

By D.L. Kendall, T. Conway, J. Rosenbek, and L. Gonzalez-Rothi

In the context of a multiple-baseline design, this study demonstrated the positive effects of an intensive behavioral treatment using a phonologically based, multi-sensory rehabilitation program to treat a 53-year-old male with severe apraxia of speech, aphasia, alexia and agraphia, 3 years after stroke onset. Treatment was administered 3 hours/day, 5 days/week for a total of 162 hours over the course of 6 months using a modified Lindamood Phoneme Sequencing Program (LiPS)(Lindamood & Lindamood, 1998). The treatment incorporated visual, tactile, kinesthetic, auditory cueing system with Socratic questioning, beginning at a phoneme level and advancing to syllable and multi-syllable word level stimuli. Results revealed a pattern of performance that increased beyond baseline variability and coincided in time with the institution of treatment and remained stable throughout treatment termination. Generalization to spontaneous speech and auditory processing measures were present. These findings suggest that intensive treatment aimed at the phonological and phonetic levels of speech production via visual, tactile, kinesthetic and auditory modalities, can aide in the establishment of motor programs that can be generalized to spontaneous production.